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万古霉素相关急性肾损伤及肾功能未恢复危险因素分析

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目的 探讨患者发生万古霉素相关急性肾损伤(VA-AKI)及VA-AKI患者肾功能未恢复的危险因素。方法 选择医院 2017 年1 月至 2022 年 12 月收治的使用万古霉素患者的临床资料,统计VA-AKI发生率及治疗药物监测(TDM)情况。分别采用单因素分析及多因素Logistic回归分析评估患者发生VA-AKI及肾功能未恢复的危险因素。结果 共纳入 158 例患者,43 例发生VA-AKI(27。22%);有 145 例患者需进行TDM,其中 61 例(42。07%)实际进行。多因素Logistic回归分析显示,合并心脏病[OR = 0。036,95%CI(0。004,0。308),P = 0。002],合并肿瘤[OR = 0。103,95%CI(0。012,0。910),P = 0。041],行外科手术[OR = 0。060,95%CI(0。011,0。324),P = 0。001]及联用袢利尿剂[OR = 0。090,95%CI(0。022,0。378),P = 0。001]是患者发生VA-AKI的独立危险因素;VA-AKI 3期[OR = 24。788,95%CI(2。567,239。343),P = 0。006]是VA-AKI患者肾功能未恢复的独立危险因素。结论 合并心脏病、合并肿瘤、行外科手术、联用袢利尿剂是患者发生VA-AKI的独立危险因素;VA-AKI 3期是患者肾功能未恢复的独立危险因素。
Analysis of Risk Factors for Vancomycin-Associated Acute Kidney Injury and Failure to Recover Renal Function
Objective To investigate the risk factors for vancomycin-associated acute kidney injury(VA-AKI)and failure to recover renal function in patients with VA-AKI.Methods Clinical data of patients treated with vancomycin in the hospital from January 2017 to December 2022 were collected,the incidence of VA-AKI and therapeutic drug monitoring(TDM)was analyzed.Univariate analysis and multivariate Logistic regression analysis were used to evaluate the risk factors for VA-AKI and failure to recover renal function in patients respectively.Results A total of 158 patients were included,43 of whom(27.22%)had VA-AKI,and 145 patients required TDM,61 of whom(42.07%)underwent it.The multivariate Logistic regression analysis showed that complication with heart disease[OR = 0.036,95%CI(0.004,0.308),P = 0.002],complication with tumors[OR = 0.103,95%CI(0.012,0.910),P = 0.041],surgery[OR = 0.060,95%CI(0.011,0.324),P = 0.001]and combination with loop diuretics[OR = 0.090,95%CI(0.022,0.378),P = 0.001]were the independent risk factors for VA-AKI in patients.VA-AKI stage three[OR = 24.788,95%CI(2.567,239.343),P = 0.006]was the independent risk factors for failure to recover renal function in patients with VA-AKI.Conclusion Complication with heart disease,tumors,surgery and combination with loop diuretics are the independent risk factors for VA-AKI in patients,and VA-AKI stages three is the independent risk factor for failure to recover renal function in patients.

vancomycinacute kidney injuryrisk factorrenal function recoveryLogistic regression analysis

徐红艳、马菲、邓琴香、黄健、徐丙发

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安徽医科大学药学院,安徽 合肥 230061

安徽医科大学第三附属医院,安徽 合肥 230061

万古霉素 急性肾损伤 危险因素 肾功能恢复 Logistic回归分析

安徽医科大学第三附属医院基础与临床合作研究提升计划培育项目

2022sfy016

2024

中国药业
重庆市食品药品监督管理局

中国药业

CSTPCD
影响因子:1.369
ISSN:1006-4931
年,卷(期):2024.33(4)
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